An ongoing discussion of the changes and frustrations with medical care by an observer, participant and active provider of it.

Friday, March 16, 2012

Docere

This morning I was watching a TED presentation by Dr. Jeff Benabio who was speaking about his vision of our profession's future. It was an interesting talk and I invite you to watch it but what struck me was the etymology of the word doctor. It comes from the Latin docere meaning "to teach". Ah, it's truly what I do all day long, with every patient. And perhaps that explains why primary care physicians have such low value in our society. After all, how well do we pay our teachers? If I was a proceduralist, a surgeon or interventional radiologist I'd be rolling in the big bucks. Maybe not as satisfied with my job, but hey, you can get satisfaction elsewhere when you make half a million bucks and year AND have three MONTHS of vacation!

Sorry, I digress...docere. This morning I explained the mediterranean diet to two individuals then recommended and demonstrated weight loss and exercise apps to them as well, listened to a woman talk about the sudden death of her husband last week (no education there, just listening), explained to my medical assistant why the prior authorization papers from the insurance company need to be put in the same spot in a 2" thick chart so next year when we have to reauthorize her medication we can find it, discussed the myriad of causes for iron-deficiency anemia to a daughter so her mom could understand in Hindi why a colonoscopy and endoscopy is necessary, described the use of "eustachian tube exercises" to a musician with allergies who is having hearing problems (and why they work), explained how and why MRSA is now a community-acquired disease instead of just from health-care facilities and discussed how a young woman's elevated blood pressure might be related to her increased use of NSAIDs. Wow, while I had this dim awareness of teaching, today was the first quantification of that in a typical morning and I am impressed.

So it turns out that I really enjoy teaching, even though I would never have chosen it as a profession. Most of my patients are motivated to learn and want to make changes. While they may occasionally be resentful of what I tell them, most of them want to have healthier lifestyles and my middle class population has the economic wherewithal to hire a trainer, go to a gym, join Weight Watchers, etc. Slowly I'm incorporating tech in my educational tools--I routinely use my iPhone with patients, either looking up medications, treatments or diseases with ePocrates.

My dream device would be an iPad, complete with anatomy apps that would give me an educational advantage while speaking with my patients. Someday, maybe....but my understanding, as we transition to electronic medical records (EMR), is that we will be stuck with a PC tablet and without the anatomy apps that make teaching so much more fun. Sigh.

Kathy A Nieder MD

A Family Practice physician since 1984, Dr. Nieder has watched the evolution (and devolution) of Health "care" over the years. She decided to add her voice to the discussion by making observations of the practice of medicine today, a time when the negatives often seem to outweigh the positives as patients and doctors become increasingly disenfranchised by the fragmentation of medical care. All views are solely her own.

Kathy has been fascinated by "tech" since she bought her first Apple computer for the family in 1987. She is interested in Social Media in healthcare as well as smartphone apps and their impact on patient care, especially in primary care.

She is an employed physician for Baptist Medical Associates in Louisville, KY. She enjoys partnering with her patients and believes patients who are well-informed and take an active role in their own well-being make for healthier, more satisfied people who make better lifestyle choices.

As a "primary care doc", Dr. Nieder advocates for PHYSICIAN led teams that embrace patients in not only the chronic illness setting but in preventive programs as well.

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